Search Results (948)

Background: Unhealthy alcohol use may lead to arrhythmia and cardiomyopathy, but its impact on sudden death is not well understood. Objective: To investigate the association of unhealthy alcohol use with sudden death. Methods: We conducted a case-control study in Wake County, a large (~1 million inhabitants), diverse county in North Carolina. We screened and adjudicated victims of sudden, unexpected, out-of-hospital deaths in adults aged 18–64 years reported by emergency medical services between 2013 and 2015. We randomly selected sex- and age-matched control patients from a university health system from the same county and time period. Characteristics of sudden death victims and controls were ascertained via standardized chart reviews. Unhealthy alcohol use was identified via chart review and was defined as any evidence of excessive alcohol use, such as it being stated in the social history or medical history, alcohol abuse being listed as a possible contributor to death, or alcohol-related diagnoses. We used logistic regression to estimate odds ratios (ORs) for the association of unhealthy alcohol use and sudden death, adjusting for age, sex, race, and other psychiatric diagnoses, including depression, anxiety, schizophrenia, bipolar disorder, and substance use disorders other than tobacco and alcohol. We also calculated the E-value to estimate the impact of any unmeasured confounders. Results: We identified 399 sudden death victims, of whom 374 (94%) had alcohol use data available. Among these 374 included victims, 256 (68%) were male, and 239 (62%) were White, with a median age at death of 55 years (IQR 48, 60). The demographic characteristics of the 1114 matched controls were similar to those of sudden death victims. Unhealthy alcohol use was present in 115 (31%) sudden death victims and 27 (2%) controls. In analyses adjusted for demographics only, unhealthy alcohol use was associated with a higher incidence of sudden death, with an OR of 17.5 (95% CI 11.4, 27.8). When further adjusted for other psychiatric diagnoses, the OR was 11.2 (95% CI 7.1, 18.0). The calculated E-value was 21.8, meaning an unmeasured confounder would need to be associated with both unhealthy alcohol use and sudden death by 21.8-fold to explain away the observed OR. Conclusions: Unhealthy alcohol use was strongly associated with higher sudden death risk in working-age adults. Our calculated E-value indicates it is unlikely that any unmeasured confounders alone would account for the observed association. Our findings suggest that interventions to reduce unhealthy alcohol use may be an effective strategy to prevent sudden death in working-age adults. Full article

While ovarian cancer screening is not recommended in the general population, attention has shifted to screening women with elevated hereditary risks. Although germline BRCA 1/2 pathogenic variants account for 40% of inherited ovarian cancer risk and family history (FH) remains important, known germline variants alone do not fully explain familial ovarian cancer risk. Whole-exome sequencing (WES) was performed on blood samples taken from 231 individuals, including 39 patients with high-grade serous ovarian cancer (HGSOC) and 192 healthy controls (HCs) stratified by FH. We analyzed pathogenic or likely pathogenic (P/LP) germline variants in cancer-related genes and assessed their association with family cancer history. Additionally, we performed somatic variant comparisons using 1:4 propensity score matching and analyzed clonal hematopoiesis of indeterminate potential (CHIP)-related somatic variants. P/LP germline variants were detected in 56.4% of HGSOC patients, 49.4% of controls with FH, and 33.3% without. The HGSOC group and controls with FH exhibited similar P/LP germline mutation patterns in ovarian cancer-related genes. From CHIP analysis, somatic CHIP mutations were detected in 6.3% of the HGSOC group and 8.5% in HCs. Our findings demonstrate genomic overlap between ovarian cancer patients and FH-positive individuals. Therefore, germline variant screening could be considered to facilitate early diagnosis. Full article

Vocational integration (VI) services aim to support sustainable employment for persons with disabilities. However, in individuals with spinal cord injury, evidence on effective intervention targets and the evaluation of sustainable integration remains limited. The Work–Life Study aims to build an evidence base for supporting sustainable employment in Switzerland by (1) identifying typical work–life trajectories; (2) examining key work–life transitions and their predictors; (3) establishing a multi-state model for intervention targets; (4) exploring individual work–life narratives; and (5) developing guidelines for personalized VI practice. The study combines a mixed methods design with a collaborative Integrated Knowledge Translation approach, actively involving VI professionals and individuals with spinal cord injury. Participants are recruited from the Swiss Spinal Cord Injury Cohort Study (SwiSCI). Work–life history data are collected through a Biographical Survey and Biographical Interviews and analyzed alongside SwiSCI data. Guideline development includes a stakeholder meeting with representatives from the Swiss Paraplegic Group, spinal cord injury clinics, individuals with spinal cord injury, employers, and disability insurers. Of 2041 eligible SwiSCI participants, 478 (23.4%) completed the Biographical Survey (median age 57.5 years; median time since injury 19.1 years), with responders and non-responders showing comparable characteristics. Work–life data closely matched existing SwiSCI data (rho > 0.8), indicating good recall. The resulting guidelines will help VI providers coordinate rehabilitation services to optimally promote sustainable employment for individuals with spinal cord injury. Full article

Background: Thoracic aortic aneurysm (TAA) remains a high-risk vascular condition despite major advances in imaging surveillance, operative repair, and endovascular therapy. Medical management still relies largely on blood pressure control and global cardiovascular risk reduction. Renin–angiotensin–aldosterone system (RAAS) inhibitors are frequently used in TAA, but contemporary data evaluating survival and cardiovascular outcomes in broad TAA populations are limited. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and sodium-glucose cotransporter-2 inhibitors (SGLT2 inhibitors) have established cardiometabolic benefits, yet their role in TAA has not been well defined. Methods: We performed a retrospective multicenter cohort study of adults with imaging-confirmed TAA diagnosed between 1 January 2018 and 1 January 2026 using a Mayo Clinic electronic data platform encompassing more than 15 million patient records. Primary exposures were documented use of RAAS inhibitors, GLP-1 RAs, and SGLT2 inhibitors, evaluated individually and in prespecified combination-therapy analyses. Propensity score matching was used to balance demographics, comorbidities, aortic procedural history, and concomitant cardiovascular medications. Primary outcomes were all-cause mortality and major adverse cardiovascular events (MACE) through 60 months. Results: The study included 162,126 patients with TAA. After matching, RAAS inhibitor use was associated with higher 60-month overall survival (88.3% vs. 85.5%; hazard ratio [HR], 0.79; 95% CI, 0.76–0.83; p < 0.001) and MACE-free survival (86.1% vs. 84.2%; HR, 0.87; 95% CI, 0.83–0.91; p < 0.001). GLP-1 RA therapy was associated with higher overall survival (97.5% vs. 92.5%; HR, 0.32; 95% CI, 0.27–0.38; p < 0.001) and MACE-free survival (93.2% vs. 89.3%; HR, 0.62; 95% CI, 0.56–0.70; p < 0.001). SGLT2 inhibitor therapy was similarly associated with higher overall survival (89.8% vs. 81.5%; HR, 0.51; 95% CI, 0.47–0.54; p < 0.001) and MACE-free survival (86.3% vs. 79.1%; HR, 0.62; 95% CI, 0.58–0.66; p < 0.001). Combination therapy with RAAS inhibitors plus either GLP-1 RAs or SGLT2 inhibitors was associated with incremental improvements in overall survival and MACE-free survival compared with GLP-1 RA or SGLT2 inhibitor monotherapy. Conclusions: In this large propensity-matched TAA cohort, RAAS inhibitors, GLP-1 RAs, and SGLT2 inhibitors were each associated with improved survival and fewer major cardiovascular events, with additional benefit observed for RAAS-based combination therapy. These findings support further prospective investigation of integrated cardiometabolic and vascular-targeted therapy in TAA, while underscoring that observational associations should not be interpreted as proof of aneurysm-specific disease modification. Full article

Background/Objectives: Staged resection with temporizing vacuum-assisted closure (VAC) has been adopted to facilitate margin assessment and local control of soft tissue sarcomas (STS). Accordingly, the objective of this study is to compare rates of local recurrence (LR) among superficial STS patients treated with and without temporizing VAC therapy. Methods: We conducted a multi-institutional retrospective cohort study of superficial STS patients treated at three tertiary care centers. Patients were matched by grade, and descriptive statistics and multivariate binary logistic regression were performed. Results: After matching, 314 superficial STS patients were included in analysis. VAC patients were more likely to present with a history of prior unplanned excision (p = 0.024), with recurrent disease (p = 0.004), harbor a diagnosis of myxofibrosarcoma (p < 0.001), and have positive initial surgical margins (p < 0.001). After multivariate analysis, VAC use remained independently associated with increased LR rates (OR = 4.117; p = 0.003). Conclusions: In this multi-institutional analysis of superficial STS patients, staged resection with temporizing VAC was not associated with improved LR rates. Rather, the VAC cohort represented distinctly higher-risk tumor biology and complex oncologic presentations, in whom the risk of LR may not be fully mitigated by surgical staging alone. Full article

To reveal the nonlinear instability mechanism by which the three-degree-of-freedom rotor system of a magnetic-liquid double suspension bearing transforms from stable suspension to periodic vibration, a nonlinear dynamic model considering electromagnetic suspension force, hydrostatic supporting force, rotor unbalance force, and liquid film resistance is established. The equilibrium point of the system is linearized, and the Hopf bifurcation boundary is determined using the Routh–Hurwitz criterion. Numerical simulations are then carried out to investigate the effects of the initial current i₀, supply flow rate q₀, and different initial disturbances on the displacement time histories, phase trajectories, and spatial phase trajectories of the rotor. The results show that, under the given system parameters, the Hopf bifurcation boundary is 0.61 A for the initial current and 9.62 × 10⁻⁵ m³/s for the supply flow rate. Current variation mainly affects electromagnetic stiffness and nonlinear electromagnetic force, whereas flow rate variation primarily changes the hydrostatic load capacity and oil film damping characteristics. Under different initial disturbances, the system may exhibit amplitude attenuation, recovery to stable suspension, or finite amplitude periodic vibration. Experimental results show good agreement with numerical simulations in terms of frequency spectra, displacement time histories, and phase trajectories, thereby verifying the effectiveness of the proposed three-degree-of-freedom dynamic model and Hopf bifurcation analysis method. The results can provide theoretical guidance for parameter matching, stability evaluation, and self-excited vibration suppression of magnetic-liquid double suspension bearings. Full article

Background/Objectives: Dental anxiety (DA) is a well-known obstacle affecting dental care in children. Children living in orphanages are a special population with healthcare needs. The aim of the study was to assess DA among children living in orphanages compared to those living with both biological parents. Methods: This frequency-matched case–control study included 61 children living in orphanages in Jeddah city and 122 age- and gender-matched peers living with both parents in Jeddah, Saudi Arabia. Demographic and background data, including medical history, dental visit history, and Adverse Family Experiences (AFEs), were completed by the caregiver. Dental anxiety was assessed subjectively using the self-reported Abeer Children Dental Anxiety Scale (ACDAS) and objectively by the Venham Clinical Anxiety Rating Scale (VCARS). Results: The prevalence of children with DA in the study sample among those living in orphanages was 18%. AFEs were significantly higher among children living in orphanages (96.7% vs. 32%, p < 0.001). ACDAS and VCARS showed fewer children with DA living in orphanages compared to children living with both parents. Logistic regression showed that living in orphanages decreased the adjusted odds ratio (AOR) of dental anxiety according to ACDAS (AOR = 0.36; p = 0.06) and VCARS (AOR = 0.43, p = 0.040). Conclusions: Although children living in orphanages presented with lower DA than those living with both parents, this may point to differences in emotional expression rather than true emotional state. Clinicians should not rely only on behavioral observations when treating institutionalized children. Full article

Introduction: The Lebranche mullet (Mugil liza) is a commercially important fish species in southeastern and southern Brazil, which serves as the primary spawning ground for the Southern stock that supports the Brazilian industrial seine fleet. However, this stock’s distribution extends into Argentine waters (northern Patagonian shelf), and the connectivity between mullets caught in Brazil and their breeding areas across South America remains poorly understood. The authors hypothesized that adult mullets landed by the Brazilian fleet consist of two distinct groups: A local group originating in Brazilian waters (BR1) and a migratory group (BR2) that uses nursery areas in Argentina (AR). BR2 presumably returns to its original nursery grounds after spawning, to recover reproductive tissues, following a different migratory pattern than BR1. Objectives: To test this, the study analyzed the micro-chemical life history of 134 otoliths from mullets aged 0+ to 11 years using LA-ICP-MS. Methodology: Two elemental ratios (Ba/Ca and Sr/Ca) were measured from the otolith core to the edge and modelled using a generalized additive model for scale and shape (GAMLSS). Life history transitions were evaluated by pairwise comparisons of fitted values among ages. Results: GAMLSS showed that Ba/Ca ratios differed significantly among groups (AR ≠ BR1 ≠ BR2). In contrast, Sr/Ca ratios were similar between AR and BR2 during the first four years of life, significantly differing from those of BR1. Using empirically established thresholds for estuarine vs. marine habitats, the study determined that BR2 individuals leave nursery areas between ages 5 and 6, migrate back around age 8, and live there one last time after age 10 (the species’ maximum age). BR1 leaves nurseries after age 4 and returns between ages 5 and 6, exhibiting a shorter reproductive cycle. Importantly, the analysis of reproductive tissue mass showed that the weight after age 7 approximately matched the weight at age 3. After recovery, reproductive tissues doubled in weight before the second migration to spawn at sea. Conclusions: These findings provide crucial insights into M. liza’s life cycle, highlighting the need for shared stock management not only with neighboring nations (Argentina and Brazil) but also on a regional scale. Full article

Mechanistic interpretability seeks to reverse-engineer the computational circuits within large language models, but current methods rely on exhaustive or heuristic search over exponentially many feature interactions. This paper introduces Active Circuit Discovery (ACD), a framework that combines attribution-graph analysis with active inference to select interventions efficiently. ACD uses Anthropic’s circuit-tracer library as its attributiongraph backend, applying Edge Attribution Patching with transcoders to identify the active transcoder features for each prompt. A partially observable Markov decision process (POMDP) agent, implemented with pymdp, maintains a multi-factor generative model of feature importance, layer role, and causal influence. At each step, the agent selects both a target feature and an intervention type (ablation, activation patching, or feature steering) by minimising Expected Free Energy over the joint feature–action space, and it learns its observation model online through Dirichlet parameter updates. ACD is an interventionselection layer over existing attribution-graph tools; it is not a whole-circuit discovery method, and no claim of state-of-the-art circuit discovery is made. The framework is evaluated on Gemma-2-2B (26 layers) and Llama-3.2-1B (16 layers) across four settings: Indirect Object Identification (IOI), multi-step reasoning, feature steering, and a multidomain benchmark spanning geography, mathematics, science, logic, and history. With a budget of 20 interventions per prompt, an ablation-only agent scored by bounded oracle efficiency against the ablation oracle reaches 82.0% efficiency on Gemma IOI and 73.0% on Gemma multi-step. It exceeds random selection by 43.5% (relative) on Gemma IOI (paired permutation p = 0.031) and is competitive with greedy ranking, a heuristic UCB bandit, and a plain UCB baseline. A direct Edge-Attribution-Patching ranking is itself a strong baseline that the agent does not consistently surpass, and on Llama multi-step the agent reaches 9.3% efficiency (37.8% with finer layer-role bins). All comparisons report bootstrap 95% confidence intervals. The full multi-action agent is characterised separately by a Relative Cumulative KL, a steering-driven amplification factor reported apart from the bounded efficiency. Feature steering changes the top-1 prediction in a dose-dependent manner, but a matched random-feature control shows that circuit-selected features are only marginally, and not significantly, more steerable than random active features at large multipliers, indicating that part of the effect is generic activation scaling. Multi-domain analysis shows task-dependent circuit structure, with IOI circuits concentrated in late layers and reasoning and scientific knowledge recruiting early and middle layers. Code, notebooks (free T4), AMD64/aarch64 Docker images, and raw results are publicly available. Full article

Background/Objectives: Injury occurrence in physically active young adults is considered a multifactorial phenomenon influenced by body composition and training-related characteristics. This study aimed to investigate the multidimensional relationships between body composition, training context variables, and injury phenotypes in physically active university students using exploratory multivariate approaches. Methods: The study included 418 physically active university students. Participants completed questionnaires regarding injury history, physical activity, and sport participation and underwent standardized anthropometric and body composition assessments. Analyses included Kendall’s Tau correlations, multiple correspondence analysis (MCA), hierarchical clustering, heatmap phenotyping, tanglegram-based clustering analysis, and distance-based redundancy analysis (dbRDA). The tanglegram analyses were intended as exploratory structure-matching procedures designed to evaluate similarities in hierarchical organization between domains rather than direct biological associations, causal relationships, or predictive effects. Results: Weak but significant associations were observed between selected body composition variables and injury outcomes, particularly for skeletal-muscle-related indicators and lower limb injuries. MCA and clustering analyses identified partially differentiated sport-training profiles and exploratory injury-burden phenotypes. Topology-based cross-domain matching analyses suggested partial structural correspondence between body composition, training context, and injury phenotypes; however, the most anatomically coherent patterns were observed for local body composition variables. Nevertheless, overall cross-domain concordance remained weak-to-moderate. dbRDA demonstrated statistically significant but weak associations for body composition (adjusted R² = 0.027, p = 0.001) and the combined explanatory model (adjusted R² = 0.022, p = 0.023), whereas the training context model was not significant (adjusted R² = 0.002, p = 0.304). Conclusions: Injury occurrence was weakly associated with body composition and training context characteristics within a multidimensional exploratory framework. The findings are consistent with the interpretation of injury occurrence as a heterogeneous and predominantly multifactorial phenomenon and highlight the utility of multidimensional exploratory approaches for investigating complex injury-related patterns. Full article

Background: Multiple arterial grafting (MAG) is associated with superior long-term outcomes in coronary artery bypass grafting (CABG). The influence of prior myocardial infarction (MI) on outcomes following MAG remains uncertain. This study evaluates in-hospital outcomes and long-term survival of MAG in patients with and without previous MI. Methods: A retrospective single-center observational analysis of 2468 patients undergoing MAG was performed. Propensity score matching yielded 911 pairs based on preoperative variables. Kaplan–Meier survival analysis and Cox regression were used to assess long-term survival and predictors of mortality. Results: In the unmatched cohort, patients with prior MI had significantly higher rates of diabetes (30.6% vs. 23.9%, p < 0.001), smoking history (p < 0.001), and impaired left ventricular function (fair/poor LVEF: 32.4% vs. 11.1%, p < 0.001), along with higher logistic EuroSCORE (3.81 vs. 3.11, p < 0.001). After matching, baseline characteristics were balanced. In-hospital outcomes, including 30-day mortality (1.5% vs. 1.9%, p = 0.587), stroke, reoperation, and renal complications, were similar. Long-term survival at 10, 15, and 20 years was comparable (log-rank p = 0.814). Multivariate Cox regression identified age (HR 1.065, p < 0.001), NYHA class, diabetes (HR 0.779, p = 0.008), and off-pump CABG (HR 1.444, p < 0.001) as independent predictors of mortality. Prior MI was not associated with increased long-term mortality (HR 0.872, p = 0.105). Conclusions: Despite worse baseline risk profiles, patients with prior MI undergoing MAG had equivalent in-hospital outcomes and long-term survival. MAG remains a robust revascularization strategy irrespective of MI history, supporting its broader use in CABG. These findings should be interpreted in the context of a single-center experience from a high-volume arterial grafting program. Full article

Implantation failure remains a major challenge in IVF, and the contribution of the gut microbiota to implantation success is still poorly defined. We conducted a pilot matched case–control study (February 2023–December 2024) to compare gut microbiota profiles between women with RIF (defined according to ESHRE good practice recommendations) and fertile controls with documented fertility (≥1 prior spontaneous pregnancy). All participants underwent standardized clinical and nutritional assessment of medical history, dietary habits, anthropometry, and body composition. Stool samples were collected for 16S rRNA gene sequencing. In women with RIF, sampling occurred within 1 year after the last failed embryo transfer. Of 45 enrolled women, 41 completed the study (20 RIF and 21 controls; mean age 38.46 ± 4.53 years), with no significant between-group age differences. Women with RIF showed reduced alpha diversity (Shannon p = 0.003; inverse Simpson p = 0.002) and a distinct community structure versus controls (Bray–Curtis PERMANOVA F = 7.16; R² = 0.16; p = 0.001), which remained significant after adjustment for clinical covariates including waist-to-hip ratio (p = 0.018). At the phylum level, women with RIF had fewer Firmicutes (52.7% vs. 65.0%; p = 0.012) and more Proteobacteria (9.1% vs. 3.6%; p < 0.001). These findings support an association between gut dysbiosis and a history of implantation failures and warrant confirmation in larger, longitudinal cohorts. Full article

Fraud detection models often achieve a strong ranking performance through black-box ensembles, but operational deployment also requires calibration, low explanation cost, and auditable scoring logic. This study develops an interpretable fraud-detection pipeline for IEEE-CIS by combining a 63-variable causal concept bank with teacher-guided additive Explainable Boosting Machine (EBM) students. The concept bank summarizes the temporal state, entity history, novelty/reuse, identity missingness, and aggregate deviation. Experiments use a chronological out-of-time split and a stricter pseudo-entity-disjoint holdout. In the main three-seed evaluation, the CatBoost predictive ceiling and XGBoost teacher achieved PR-AUC 0.489 ± 0.001 and 0.478 ± 0.003, respectively. Among interpretable models, concept-only EBM reached 0.189 ± 0.000, raw-only EBMs reached 0.372 ± 0.005 (top-k = 8) and 0.383 ± 0.002 (top-k = 12), and hybrid EBMs reached 0.407 ± 0.003 (top-k = 8) and 0.407 ± 0.004 (top-k = 12), consistently improving over matched raw-only additive baselines. The final top-k = 8 hybrid reduced input features from 154 to 71, achieved about 9.7× faster inference than XGBoost, remained close to XGBoost in ECE-15 calibration (0.01587 vs. 0.01611) while having a higher Brier score, and produced native local explanations far faster than XGBoost + SHAP. The results position CatBoost as the predictive ceiling and hybrid EBM as a benchmark-supported, deployment-relevant interpretable compromise for applied financial risk-screening workflows, rather than as a production-validated fraud-monitoring system. Full article

Long horizontal wells in high-permeability fault-block reservoirs may intersect multiple faults, leading to complex pressure-transient responses, strong parameter coupling in conventional well-test interpretation, inefficient manual history matching, and pronounced non-uniqueness in fault-property identification. To address these challenges, this study proposes a physics-regularized neural inversion framework based on a PINN parameterization and low-weight physics regularization for well-test parameter inversion in long horizontal wells intersecting multiple faults. The proposed method takes the multiple-fault pressure response of a long horizontal well as the target problem. Both the pressure–drawdown curve and the pressure–drawdown derivative curve are used as data constraints. At the same time, parameter scaling and stage-wise training are introduced to jointly invert the reservoir permeability, fault transmissibility coefficient, skin factor, and effective producing length of the horizontal well. Considering that the simplified line-source forward model is not fully consistent with the two-dimensional pressure-diffusion equation and the fault-interface residuals, a physics-loss consistency test is performed to determine safe weighting ranges for the PDE residual and the fault-interface residual. These residuals are then incorporated into the training process as low-weight physics regularization terms to improve the physical plausibility of the inversion results. Results from the base case, different fault types, multiple-fault combinations, noise-robustness tests, ablation experiments, and method comparisons show that the proposed method can stably fit pressure–drawdown and pressure–drawdown derivative curves and effectively identify key well-test parameters in single-fault cases and some multiple-fault cases. In single-fault cases, the order of magnitude of the fault transmissibility coefficient can be identified stably. Reliable inversion performance is obtained for medium- to high-transmissibility faults and some multiple-fault combinations. In contrast, ambiguity remains between sealing faults and strong-baffle faults in multiple low-transmissibility fault combinations. The results further indicate that, under multiple random initializations, the physics-regularized neural inversion framework provides improved inversion stability in the tested synthetic low-transmissibility multiple-fault cases compared with the traditional least-squares method. Therefore, the proposed framework can serve as an intelligent auxiliary tool for well-test parameter inversion and fault-connectivity evaluation in complex fault-block reservoirs. Nevertheless, fine discrimination of low-transmissibility faults and interpretation of highly noisy field data still require joint constraints from geological, seismic, and production-dynamic information. A preliminary reduced field PINN fitting test using the well X falloff event further provides an engineering-scale applicability check for real pressure-transient data, with a pressure NRMSE of 2.457% for the extracted shut-in response. Full article

Background: Despite a decline in lung cancer in the U.S., lung cancer among never-smoking Asian American (AsA) women is rising, and subgroup aggregation obscures heterogeneity. We compared primary lung cancer prevalence across disaggregated AsA subgroups and examined factors associated with prevalence such as personal- and family-cancer histories versus Non-Hispanic Whites (NHWs). Methods: This cross-sectional study analyzed electronic health records of AsA women (≥18) in a large Northern California health system (2010–2022). Lung cancer cases were obtained from the hospital registry and categorized by smoking status and self-reported ethnicity. Adjusted prevalence ratios (aPRs) were estimated using targeted maximum likelihood estimation, accounting for sociodemographic, smoking, and clinical covariates. Results: Among 1,843,119 women, 8651 had primary lung cancer; 2429 were never-smokers. In AsA never-smokers, aPRs and 95% confidence intervals versus age-matched NHW were: Chinese (3.36, [3.20–3.53]), Filipino (2.68, [2.55–2.82]), Vietnamese (2.07, [1.96–2.18]), Japanese (1.99, [1.89–2.10]), Korean (1.90, [1.80–2.00]), and Other Asian (0.35, [0.33–0.37]). Personal cancer-history reflected an increase in prevalence among Korean patients (2.91, [2.76–3.06]) while family cancer-history demonstrated increased prevalence among Chinese patients (1.51, [1.42–1.60]). Among women with uterine cancer, Chinese patients had higher lung-cancer prevalence than NHW (1.91, [1.58–2.31]). Conclusions: Never-smoking disaggregated AsA women show heterogeneous lung cancer prevalence, with higher prevalence in Korean women with personal cancer-history and in Chinese women with family cancer-history compared with NHW, supporting history-informed and ethnic-specific lung cancer screenings. Full article